Tripta Chandler

The applicant was injured in a motor vehicle accident and applied for statutory accident benefits.

The parties resolved the substantive issues prior to a scheduled preliminary issue hearing, but the issue of arbitration expenses remained in dispute.

The insurer argued that the arbitrator lacked jurisdiction to award expenses because no hearing on the merits had taken place.

The arbitrator held that under the Insurance Act and the Dispute Resolution Practice Code, the Commission has explicit jurisdiction to decide a claim for expenses in relation to a matter that has been resolved prior to a preliminary issue hearing.

The applicant was injured in a motor vehicle accident and received statutory accident benefits.

The insurer terminated his weekly income replacement benefits, and the applicant applied for arbitration.

The insurer requested that the applicant attend updated examinations with its medical and psychological experts, which the applicant refused.

On a preliminary issue, the arbitrator held that the insurer's request was not reasonable under section 42 of the Statutory Accident Benefits Schedule, as the applicant's condition had not changed and the insurer merely sought to bolster its evidence for the hearing.

The applicant's refusal to attend had no consequence.

The applicant was struck by an uninsured vehicle while walking across a street.

She applied for statutory accident benefits from Wawanesa, which insured the driver of the vehicle on another policy.

Wawanesa returned the application, claiming it was not an insurer because the driver had cancelled her liability coverage days before the accident.

The arbitrator held that Wawanesa, having initially advised the applicant's counsel that the driver was insured, created a sufficient nexus to be considered an insurer.

As the first insurer to receive the application, Wawanesa was required under O. Reg. 283/95 to respond to the application and pay benefits pending any priority dispute.

The applicant in a statutory accident benefits dispute served a late psychovocational assessment report shortly before the arbitration hearing.

The insurer brought a motion seeking an order that the applicant attend a psychovocational assessment by its own expert to respond to the late report.

The arbitrator granted the motion, holding that fairness and the arbitrator's duty to control the hearing process required that the insurer be given a reasonable opportunity to respond, which included an independent assessment of the applicant.